Don’t scratch that winter itch: Measures for keeping skin moist

As the cold weather of winter descends upon much of the United States, millions of Americans will start — or intensify — their daily scratching frequency. For those who wish to maximize their experience of itching: move to a cold or desert location, take long, hot showers while scrubbing the skin vigorously with scented soap, and don wool clothing after forcefully drying off. Additionally, make sure ambient humidity remains below 30 percent and scratch that itch really, really hard, for more scratching begets more itching!
 
Cold air holds lower amounts of water vapor, and when that same air enters our homes and warms up, the humidity percentage drops even more, since warm air holds a higher density of water. With low humidity — and aging — the top, dead layer of skin sticks around longer and looks scaly, but it holds moisture less efficiently and develops cracks, which let irritating chemicals through and allow tiny fibers to stimulate itching and stinging.

What can be done to reduce this winter scourge of dry skin and the feeding-frenzy cycle of itch that leads to scratching — which leads to more itching and scratching?

Moisture must be added to the skin and more effectively maintained in the skin. Simply drinking more water will not achieve that. Daily warm — not hot — showers or baths should last no more than five minutes. White, unscented soap should be used only on hairy and oily areas that can cause an odor (scalp, armpits, groin). Gently pat yourself dry with a towel in order to leave some moisture on the skin, and within two minutes of exiting the bath or shower, put a moisturizer on areas most prone to itching.
 
Thicker moisturizers (ointments and creams) work far better than those containing high concentrations of water (lotions). Creams best bridge the dual needs of comfort and effectiveness, and those containing lactic acid (or lactate) help remove dead, scaly skin, while those with ceramides replace the key water-binding lipids missing in dry skin. Avoid placing any irritants on the skin, such as scented or alcohol-containing products. Throughout the day, wash hands with cold water and soap so that the soap cannot dry out the skin; it will rub right off without getting absorbed.
 
Wearing long sleeves preserves moisture on the arms, and smooth fabrics of 100-percent cotton or silk do not aggravate sensitive skin. Even doing all the above may not work if the ambient humidity drops below 30 percent. Central humidifiers, room humidifiers, and even heating a big pot of distilled or demineralized water on the stove can help to humidify your living space — and most importantly your bedroom.

With such simple activities, the dark days of winter can grow brighter when you are free of aggravating itching.

THOMAS W. MCGOVERN, M.D., is a dermatologist in Fort Wayne, IN. He co-hosts the award-winning radio show and podcast Doctor, Doctor and chairs the Catholic Medical Association Novus Medicus Committee that oversees outreach to Catholic medical students and young physicians in training.